Journal of critical care
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Journal of critical care · Dec 2014
Observational StudyRoom-temperature vs iced saline indicator injection for transpulmonary thermodilution.
Ice-cold injectate is assumed to provide best accuracy for transpulmonary thermodilution (TPTD)-derived cardiac index (CI), global end-diastolic volume index (GEDVI), and extravascular lung-water index (EVLWI). Room-temperature injectate might facilitate TPTD. Therefore, this study compares TPTD-results derived from iced injectate with room-temperature injectate TPTDs (TPTDRoom). ⋯ Room-temperature injectate TPTDs results in slight but significant overestimation of CI, GEDVI, and EVLWI. Percentage error values for GEDVIRoom and EVLWIRoom are acceptable only in case of "jugular" indicator injection.
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Journal of critical care · Dec 2014
Transcutaneous oxygen tension monitoring in critically ill patients receiving packed red blood cells.
Whether transfusions of packed red blood cells (PRBCs) affect tissue oxygenation in stable critically ill patients is still matter of discussion. The microvascular capacity for tissue oxygenation can be determined noninvasively by measuring transcutaneous oxygen tension (tcpO2). The aim of this study was to assess tissue oxygenation by measuring tcpO2 in stable critically ill patients receiving PRBC transfusions. ⋯ In stable critically ill patients, microvascular tissue oxygenation can be continuously monitored by Clark's tcpO2 electrodes. According to continuous tcpO2 measurements, the microvascular tissue oxygenation is not affected by PRBC transfusions.
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Journal of critical care · Dec 2014
Mean platelet volume is a prognostic factor in patients with acute kidney injury requiring continuous renal replacement therapy.
Platelet size has been demonstrated to reflect platelet activity and to predict poor clinical outcomes in patients with cardiovascular disease. However, the prognostic value of platelet size for mortality has not been studied in patients with acute kidney injury (AKI). ⋯ Mean platelet volume at the time of CRRT initiation may be an inexpensive and useful predictor for 28-day all-cause mortality in patients with AKI requiring CRRT.
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Journal of critical care · Dec 2014
Benefit of using a "bundled" consent for intensive care unit procedures as part of an early family meeting.
Relatives of patients in the intensive care unit (ICU) are often dissatisfied with family-physician communication. Our prospective preintervention and postintervention study tested the hypothesis that introducing this informed consent process would improve family satisfaction with the ICU process of care. ⋯ A bundled informed consent resulted in higher family satisfaction with the process of care in ICU.
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Journal of critical care · Dec 2014
Observational StudyGoal-directed therapy after cardiac surgery and the incidence of acute kidney injury.
The purpose of this study was to assess the effect of goal-directed therapy (GDT), after cardiac surgery, on the incidence of acute kidney injury (AKI). ⋯ Postoperative GDT in patients after cardiac surgery was associated with reduction in the incidence of AKI and a reduction in ICU and hospital duration of stay.